A Retrospective Analysis of Neurocognitive Impairment in Older Patients With Burn Injuries

Holmes, Emily G.; Jones, Samuel; Laughon, Sarah L.

doi:10.1016/j.psym.2017.03.002

Cited by 13 publications

(9 citation statements)

References 17 publications

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“…11,12 At two specialized burn centers, delirium was diagnosed in 16% and 39% of the admitted adults. 13,14 Risk factors for delirium have been widely investigated for surgical and nonsurgical populations, but not for burn center patients.…”

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confidence: 99%

Prevalence and Risk Factors for Delirium in Elderly Patients With Severe Burns: A Retrospective Cohort Study

Yperen

Raats

Dokter

et al. 2019

Journal of Burn Care &Amp; Research

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Little is known about delirium in elderly burn center patients. The aim of this study is to provide information on the prevalence of delirium and risk factors contributing to the onset of delirium. All patients aged 70 years or older admitted with burn injuries to the Burn Center, Maasstad Hospital, in 2011 to 2017 were eligible for inclusion. We retrospectively collected data regarding the presence of delirium, potential risk factors contributing to the onset of delirium and outcome after delirium. We included elderly 90 patients in this study. The prevalence of delirium in our population was 13% (N = 12). Risk factors for delirium were advanced age, increased American Society for Anesthesiologists score, physical impairment and the use of anticholinergic drugs during admission. Patients with delirium had a poorer outcome, with prolonged hospital stay and increased mortality 6 and 12 months after discharge. Delirium is diagnosed in 13% of the elderly patients admitted to our burn center. Risk factors for delirium found in this study are advanced age, poor physical health status, physical impairment, and the use of anticholinergic drugs. Delirium is related to poor outcomes, including prolonged hospital stay and mortality after discharge.

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confidence: 99%

Prevalence and Risk Factors for Delirium in Elderly Patients With Severe Burns: A Retrospective Cohort Study

Yperen

Raats

Dokter

et al. 2019

Journal of Burn Care &Amp; Research

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“…The included 13 studies were cohort or case–control designs, with retrospective data extracted from either electronic databases or hard copy medical charts. Five of the studies were conducted in Australia (Bail et al, 2013; Draper, Karmel, Gibson, Peut, & Anderson, 2011; Harvey, Mitchell, Brodaty, Draper, & Close, 2016; King, Jones, & Brand, 2006; Scandol, Toson, & Close, 2013), three in the United States of America (Holmes, Jones, & Laughon, 2017; Lagu et al, 2016; Sherzai et al, 2016) and one each in the United Kingdom (Fogg, Meredith, Bridges, Gould, & Griffiths, 2017), Spain (Guijarro et al, 2010), Taipei (Hu, Liao, Change, Wu, & Chen, 2012), Finland (Jämsen, Peltola, Puolakka, Eskelinen, & Lehto, 2015) and Germany (Rösler, Krause, Niehuus, & von Renteln‐Kruse, 2009). The sample size ranged from 26 to over 13,000,000 patient admissions due to the use of nationwide data sets.…”

Section: Resultsmentioning

confidence: 99%

“…The sample size ranged from 26 to over 13,000,000 patient admissions due to the use of nationwide data sets. All studies compared data from patients with dementia to those without dementia or to patients with delirium (Holmes et al, 2017). A summary of characteristics of the included studies is presented in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 13 studies, 11 reported patient length of hospital stay (Draper et al, 2011; Fogg et al, 2017; Guijarro et al, 2010; Harvey et al, 2016; Holmes et al, 2017; Hu, Liao, Chang, Wu, & Chen, 2012; Jämsen et al, 2015; King et al, 2006; Lagu et al, 2016; Scandol et al, 2013; Sherzai et al, 2016). A longer length of stay (LOS) was reported for patients with dementia compared to patients without dementia in nine studies (Draper et al, 2011; Fogg et al, 2017; Guijarro et al, 2010; Harvey et al, 2016; Holmes et al, 2017; Hu et al, 2012; Jämsen et al, 2015; King et al, 2006; Sherzai et al, 2016). Two studies reported patients with dementia had a shorter LOS than patients without dementia (Lagu et al, 2016; Scandol et al, 2013).…”

Section: Resultsmentioning

confidence: 99%

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Health outcomes of patients with dementia in acute care settings—A systematic review

Fox

MacAndrew

Ramis

2020

Int J Older People Nursing

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Background An ageing population has resulted in increased numbers of people with dementia attending acute care services; however, the impact of hospitalisation on this population is uncertain. Purpose This systematic review aimed to synthesise the available evidence on adverse health outcomes for people with dementia in acute care settings. Methods A systematic search of CINAHL, PubMed, MEDLINE, EMBASE and Scopus databases for primary research articles in English language, published from 2000 to 2017, was conducted. A protocol for the review was registered on the PROSPERO database. Results The initial search identified 5,520 records. Following removal of duplicates and assessment against inclusion criteria, 13 studies were included in the final review. Findings identify associations between patients with dementia, longer length of hospital stay and higher mortality in some situations. Heterogeneity across studies in data reporting and outcomes prevented meta‐analysis; therefore, results are presented narratively. Conclusions Certainty of findings from this review is impacted by variation in patient condition and data reporting. Additional rigorous studies on health outcomes for people with dementia during acute hospitalisation will contribute to the evidence. Implications for practice These findings along with further research examining outcomes for patients with dementia in acute care settings will inform provision of safer, quality care and optimal health outcomes for this vulnerable population.

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“…The American Psychiatric Association also specifies that delirium is characterized by inattention, disturbance of consciousness, and disorganized thinking [2]. Its occurrence is due to various pathologies, sometimes simultaneously present, such as dementia, organ functional deficits, multimorbidity, and psychiatric disorders treated with drugs that act on the central nervous system, particularly narcotics, hypnotics (such as benzodiazepines), and anticholinergics [2][3][4][5][6][7]. In addition, older age and hospitalization facilitate the onset of delirium [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Early Diagnosis of Delirium in Palliative Care Patients Decreases Mortality and Necessity of Palliative Sedation: Results of a Prospective Observational Study

Beretta¹,

Uggeri²,

Santucci³

et al. 2022

Cureus

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Introduction: Delirium in end-of-life patients is reported to be between 13% and 42% and up to 80% in the terminal phase. It is a serious clinical situation, often a cause of death due to the frequent ineffectiveness of treatments. This study aimed to assess whether and how much precocity of diagnosis, hitherto little considered, could affect the outcomes and prognosis of delirium in palliative care settings.Methods: Patients consecutively admitted to a palliative care unit (PCU) between October 2018 and December 2019, cared for both in hospice and home programs, were analyzed. All patients were subjected to a careful procedure aimed at recognizing the onset of delirium. The first step was the detection of prodromal "sentinel" symptoms related to incoming delirium. PCU staff and family members/caregivers were trained to observe the patients and immediately identify the appearance of even one symptom. The final diagnosis was performed with the 4AT (4 A's test). Patients were then included in the categories of "early" or "slow" diagnosis (cut-off: four hours) depending on the time between sentinel symptom observation and the final diagnosis of delirium.Results: Among 503 admitted patients, 95 developed delirium. Confusion was the most frequent sentinel symptom (49.5%). The early diagnosis was more frequent in hospice than in home care (p-value<0.0001). Delirium was positively resolved in 43 patients, of which 25 with an early diagnosis (p-value=0.038). Time to resolution was shorter in the case of early diagnosis (7.1 vs. 13.7 hours in hospice patients; p-value=0.018). Palliative sedation was performed on 25 patients, but only 8 of them had an early diagnosis.Conclusion: Time of diagnosis was important in determining the clinical outcomes of patients in charge of PCU who experienced delirium. The early diagnosis reduced both mortality and the necessity of palliative sedation.

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A Retrospective Analysis of Neurocognitive Impairment in Older Patients With Burn Injuries

Cited by 13 publications

References 17 publications

Prevalence and Risk Factors for Delirium in Elderly Patients With Severe Burns: A Retrospective Cohort Study

Prevalence and Risk Factors for Delirium in Elderly Patients With Severe Burns: A Retrospective Cohort Study

Health outcomes of patients with dementia in acute care settings—A systematic review

Early Diagnosis of Delirium in Palliative Care Patients Decreases Mortality and Necessity of Palliative Sedation: Results of a Prospective Observational Study

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